Provider Demographics
NPI:1205544269
Name:BRATZ, THOMAS LEE (RPH)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:LEE
Last Name:BRATZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4538 HIDDEN GULCH RD
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-8836
Mailing Address - Country:US
Mailing Address - Phone:719-250-6685
Mailing Address - Fax:
Practice Address - Street 1:14 E ALLEN ST
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-7840
Practice Address - Country:US
Practice Address - Phone:303-663-6858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist